Individual provider Active NPI

Tyler McKay Rawlins, OD

  • Optometrist
  • Lehi, UT
National Provider Identifier
1629648522
Registry record updated Jul 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
12362257-9934 Issued in UT
Practice address
3333 N Digital Dr Ste 300
Lehi, UT 84043-6694
Phone
(801) 876-6000
Fax
(385) 235-6111
NPI assigned
Jul 1, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 12362257-9934 UT Primary

Addresses

Primary practice location

3333 N Digital Dr Ste 300
Lehi, UT 84043-6694

Mailing address

3333 N Digital Dr Ste 300
Lehi, UT 84043-6694
Phone (801) 876-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210810002905 UT Practitioner - Optometry 9638573819 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Waite Vision, PLLCGroup PAC ID 6406114057, 2 clinicians

Practice addresses (Care Compare)

3333 N Digital Dr
Suite 300
Lehi, UT 84043-6694
Phone (801) 876-6000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12362257-9934UTMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Waite Vision, PLLC CurrentSince Aug 1, 2021 Accepting new patients

Locations

3333 N Digital Dr
Ste 300
Lehi, UT 84043
Phone (801) 876-6000

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1625097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625097600000",
    "number": "1629648522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 N DIGITAL DR STE 300",
            "city": "LEHI",
            "state": "UT",
            "postal_code": "840436694",
            "telephone_number": "801-876-6000",
            "fax_number": "385-235-6111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 N DIGITAL DR STE 300",
            "city": "LEHI",
            "state": "UT",
            "postal_code": "840436694",
            "telephone_number": "801-876-6000",
            "fax_number": "385-235-6111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAWLINS",
        "first_name": "TYLER",
        "middle_name": "MCKAY",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-07-01",
        "last_updated": "2021-07-01",
        "certification_date": "2021-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "UT",
            "license": "12362257-9934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lehi, UT

Sources for this page

Verify at the official NPI Registry.